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THORACIC CAVITY. RESPIRATORY DIAPHRAGM. Diaphragm. A diaphragm is a muscular sheet with an inferior and a superior fascia: Superior fascia = parietal thoracic fascia. Inferior fascia = transversalis fascia. Separates thorax and abdomen. In moderate expiration:

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thoracic cavity

THORACIC CAVITY

RESPIRATORY DIAPHRAGM

diaphragm
Diaphragm
  • A diaphragm is a muscular sheet with an inferior and a superior fascia:

Superior fascia = parietal thoracic fascia.

Inferior fascia = transversalis fascia.

  • Separates thorax and abdomen.
  • In moderate expiration:

Reaches level of 5th rib on right side and 5th IC space on left.

diaphragm origins
Diaphragm Origins
  • Sternal part:

Xiphoid process.

  • Costal part:

Lower 6 ribs and cartilages.

  • Lumbar part:

Lumbar vertebrae and crura:

Right: L1-L3

Left: L1-L2

central tendon
Central Tendon
  • “Y-shaped”
  • Attaches to lumbar vertebrae via crura.
  • Pierced by three openings (described later).
central tendon5
Central Tendon
  • Three parts to central tendon:

Right:

Largest part.

Middle:

Left:

Smallest part.

  • Fig. 2.71
crura
Crura
  • Muscular pillars
  • Originate from lumbar vertebrae:

Right from L3.

Left from L2.

Right swings left and forms a weak sphincter around the esophagus.

arcuate ligaments
Arcuate Ligaments
  • Median:

Around aortic opening.

Bridges proximal ends of crura.

  • Medial:

From deep fascia of psoas major muscle.

From transverse process to body of L1.

  • Lateral:

From deep fascia of quadratus lumborum muscle.

From transverse process of L1 to rib 12.

diaphragm openings
Diaphragm Openings
  • Caval opening:

Level T8

Inferior vena cava; right phrenic nerve

  • Esophageal opening:

Level T10

Esophagus; vagus nerves

  • Aortic opening:

Level T12

Aorta; thoracic duct; azygos vein

diaphragm innervation
Diaphragm Innervation
  • Phrenic Nerve
  • C3-5
diaphragm arterial supply
Diaphragm Arterial Supply
  • Superior aspect:

Pericardiacophrenic artery from IT.

Musculophrenic artery from IT.

Superior phrenic artery from aorta.

  • Inferior aspect:

Inferior phrenic artery from aorta.

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